The proposed P30 Center of Excellence for Biobehavioral Approaches to Symptom Management (CEBASM) builds on our successful P20 Exploratory Center for Biobehavioral Clinical Research (CBCR, P20 NR008988, McCain, PI). The CEBASM will take advantage of the synergy developed via the CBCR related to symptom management and biobehavioral outcomes as well as resources garnered and systems developed for that Center and expand them to advanced application of biobehavioral models, methods, and analyses aimed at understanding biobehavioral mechanisms, interventions, and outcomes related to symptom management with a focus on fatigue. The research base for this center of excellence is provided by Drs. Pickler, Grap, Lyon, McCain, Munro, and Elswick who collectively and in their own work have significantly advanced biobehavioral science and/or symptom management in preterm infants, patients with cancer, and in the critically ill. This group of senior investigators provided the scientific and administrative foundation for the successful P20 Center. Their expertise has guided the projects proposed here and will be instrumental in developing future biobehavioral scientists who focus on symptom management. The specific aims of the proposed P30 Center of Excellence are to 1. Expand biobehavioral research capacity for scientists conducting nursing research by centralizing research resources and infrastructure for biobehavioral clinical research focused on symptom management; 2. Advance biobehavioral approaches for symptom management, including fatigue and its associated symptoms, in diverse populations; 3. Facilitate the development and expansion of biobehavioral programs of independent, investigator initiated biobehavioral research that have a common theme of fatigue; 4. Establish a mature environment of sustainable biobehavioral research in symptom management that is clinically focused and interdisciplinary in nature. The aims of the proposed P30 Center of Excellence are relevant to several areas of opportunity identified in NINR's Strategic Plan including: 1) developing or improving biobehavioral methods, measures, and intervention strategies associated with symptom clusters; 2) developing technologies to facilitate early detection of symptoms; 3) delineating causative mechanisms underlying symptoms; 4) developing and testing interventions that improve patient response and adaptation to symptoms and symptom clusters in discrete and co-morbid conditions; 5) designing strategies to improve management of symptoms over disease trajectories; and 6) eliminating health disparities by understanding disease manifestations and testing innovative intervention in underserved populations. Further, the proposed Center will meet NINR's scientific advancement strategies of integrating biology and behavior and preparing the next generation of nurse scientists. Research emanating from the Center will delineate biobehavioral mechanisms underlying symptom management, with a focus on fatigue as a common symptom across studies and programs of biobehavioral clinical research. Center projects will address African American adolescents, adults with fatigue associated with sickle cell disease and women with breast cancer who experience fatigue and its associated constellation of symptoms that contributes to cognitive dysfunction. Research will also test biobehaviorally focused interventions to improve outcomes in pregnant African American women, women with fibromyalgia, and women with cardiovascular risk. Ultimately, Center research will lead to further interventions to improve patient outcomes related to complex constellations of symptoms, including the common symptom of fatigue. The proposed Center will: enhance research infrastructure at VCU by (a) expanding and targeting resources to promote and support research focused on the biobehavioral mechanisms, management, and outcomes of complex constellations of symptoms, including the commonly occurring symptom of fatigue; (b) expanding the biobehavioral understanding of symptom constellations in persons from diverse populations; (c) increasing opportunities for beginning investigators involved in interdisciplinary research to further develop programs of research using biobehavioral models and methods; and (d) planning for and developing sustainable research programs by building an active, interdisciplinary collaborative foundation for biobehavioral approaches to symptom management. Description of Administrative Structure The structure for this new Center is evolved to show the increased complexity and scientific focus of our work. The administrative structure of the CEBASM is illustrated in Figure 1. The Center will enact its aims through the implementation of five funded research projects and through the work of its cores for Biobehavioral Science (BSC), Biobehavioral Measurement (BSM), and Data Services and Analysis (DSA). The Center will enhance the expertise of Project Directors (PDs) in biobehavioral clinical research by mentorship, training, and research experience and will help develop expertise of Center and other VCU investigators in biobehavioral clinical research focused on symptom management with a focus on fatigue. The Center will also develop strategies to speed the dissemination of research findings into interdisciplinary scientific literature, including advancement toward translation into practice. Center activities will be assessed using a thorough evaluation plan that includes measurable goals and both summative and formative evaluations.